Wednesday, June 19, 2013

Classification of the Largest Human Organ

Current references state that in 1975, dermatologist, Thomas Fitzpatrick, MD, PhD, developed a scale to classify a person's complexion and tolerance to sunlight.  Reaction to the sun, genetic background, and natural skin color determine what is known as Fitzpatrick skin type, based on a series of questions an individual is asked which are then scored.  This scale is used for diagnostic and therapeutic purposes in the treatment of diseases of the skin.  The initial, 1975 classification is outlined below followed by dolls to illustrate (as close as possible) the complexion of each type.

Dolls illustrate Fitzpatrick skin types I, II, and III:  fairest, fair, dark white, respectively.
Fitzpatrick's study was conducted in Brisbane, Australia in 1972 using paid Australian volunteers.  Dark-skinned people were excluded from the initial test and scale.  According to Fitzpatrick's article,  "The Validity of Practicality and Sun-reactive Skin Types I-VI," published in June 1988 in the Journal of American Medical Association (JAMA) Dermatology, "The concept of sun-reactive 'skin typing' was created in 1975 for a specific need: to be able to classify persons with white skin in order to select the correct initial doses of ultraviolet A (UVA) (in joules per cubic centimeter) in the application of the then newly developed technique for the treatment of psoriasis—oral methoxsalen photochemotherapy (PUVA)."

Psoriasis, named for the Greek word psōra meaning "itch," is a chronic, non-contagious disease characterized by inflamed lesions covered with silvery-white scabs of dead skin.  It is most common in fair-skinned people; rare in those with dark skin.  (This may be the reason for the initial exclusion of dark-skinned people from Fitzpatrick's skin typing—even though current references to the scale indicate it was devised to classify a person's complexion and tolerance to sunlight.)

Nevertheless, by the late 1980s, three additional skin types, to include darker and dark skinned people, were added to the Fitzpatrick scale.  Again, these types are illustrated using dolls and described below.

Dolls illustrate Fitzpatrick skin types III, IV, and VI:  olive, dark, darkest, respectively.

Those interested in taking the quiz used to determine skin type can do so here.  The bottom of the page at the previous link contains an image of a person with class I skin type.  Click the links numbered 2-6 to advance to the subsequent five skin type illustrations.  Another illustration of the now six types that comprise Fitzpatrick's classification of the largest organ of the human body, the skin,  can be seen here.

1988 JAMA Dermatology Article by Fitzpatrick
Fitzpatrick Skin Typing:  Applications in Dermatology
Remembering Thomas B. Fitzpatrick


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  1. I have heard the term olive complexion but always equated it with people of middle eastern descent. However, in recent years, just about every interracial novel I read with a black heroine, she is described as olive skinned with almond eyes. But in novels where all parties are black, she's just light, brown or dark skinned and plain old eye balls.

    Distinctions like that are iffy to me. I feel the same way about natural hair classifications.

    You are so educational and always get me thinking!

  2. Hi Muff,

    I was described as having an olive complexion on my birth certificate. As a young child, I had no idea what that meant. I think at one point I asked my mother if I was green when I was born. What else would a 9 or 10 year-old think?

    It took me a while to understand the natural hair classifications and attempt to determine my type, which I still haven't been able to do because it's not all one type.

    I encountered the Fitzpatrick skin classification scale several months ago and needed to broaden my knowledge about it... so I did. I thought it would be interesting to transform the "human illustration" of the scale into doll form.


  3. Interesting! I am dark but had never sunburned until I went to Disney Land at 13. I never knew I could burn until then. As for Psoriasis, I have known many black people with it. To me, it looks even worse the darker your are.

  4. Thanks for commenting, Ms. Leo. We tan and we burn, too. It takes a little longer for darker skin pigment, but it happens. I suppose Fitzpatrick didn't realize this or did not care to test the effects of sun exposure on all skin types when he initially conducted his study.

    It also known that darker skinned people can develop skin cancer (melanoma) and die from it at greater numbers than whites because it goes undetected and is usually at the final stages by the time a diagnosis is made. So we tan, we burn, and we need sun protection, too.



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